You Can't Make This Stuff Up (#6)

As a neuropsychologist, I have expertise in understanding the neurological and psychological factors that can contribute to a patient's symptoms. For example, a patient can report memory problems because of a traumatic brain injury or because of depression. Many people are not aware that seizures can sometimes have a psychological origin and not be related to brain dysfunction. These are sometimes referred to as pseudoseizures or psychogenic seizures. Determining if a seizure is psychological can be difficult, but important, because the treatments are vastly different.

Well one day, when I was a working one of the hospital shifts, a patient was on the unit who the staff suspected was having pseudoseizures. However, despite numerous expensive diagnostic tests, they had been unable to prove this. A video camera was hooked up in his room so that he could be monitored from the nursing station, which is where all the charts are kept and where medical staff usually stays.

All of a sudden, the patient began having a "seizure-like episode," violently flailing around in bed and moaning. In a true seizure, environmental stimuli (e.g., yelling, slap in the face) cannot stop it. It must run its course. Knowing this, I stood up and called the patient's room. As the phone rang, the staff looked on in anticipation. Everyone watched as the patient suddenly stopped flailing around, looked around the room, picked up the phone, and said "Hello." Everyone just looked at me in amazement. After all of those fancy medical tests, a simple telephone call confirmed the presence of psychological seizures. Sometimes simpler is better.

VERY Important Link

Want to know if your doctor likes to beat up his/her patients or is under formal disciplinary action? If so, then the following link is crucial to keep in a safe place. I learned a long time ago that consumer protection efforts can save you alot of grief. Just a simple click of the mouse is all it takes. The link below takes you to the Federation of State Medical Boards, which provides links to all ot the state medical boards. From there, you can look up your current physicians, dentisit, physician assistant, and nurse practitioner (depending on the state). If discipilary action was taken, an adequate description will be provided. Please pass the link on to friends and family. Here it is:

Federation of State Medical Boards

You Can't Make This Stuff Up (#5)

You never know what you are going to see when you walk out of an elevator. One day, I was taking the elevator up to a rehabilitation floor. Unbeknownst to me, a man had been hospitalized for trying to kill himself by chopping one of his hands off with an axe. Paramedics were able to save him. Surgeons reattached his hand.

While the patient was recovering from surgery, he was very combative, did not want to stay in bed, was pulling out his IV lines, etc. He was in such a delirious state one morning that he actually ripped off his hand! This happened right before I was about to walk off the elevator. When the doors opened, I heard loud screams and saw a man violently swinging a handless arm that had a metal rod sticking out of it. Blood was flying everywhere and the patient collapsed to the floor. One of the staff members attending to him yelled out loud: "Hey, can someone give me a hand!" As I've said time and time again, you can't make this stuff up.

You can't make this stuff up (#4)

I was thinking of the original situation I encountered that would constitute grounds for a "You Can't Make This Stuff Up" entry and I dug way back into the memory banks for this next one. This story dates back to when I was beginning my graduate school training in Florida. At the time, I had a patient with antisocial personality disorder. When the average person hears “antisocial” they think of someone who likes to stay by him/herself. But antisocial personality disorder is something entirely different. Basically, it is someone with a longstanding pattern of violating the rights of others without remorse. It is not uncommon for such individuals to abuse animals.

So this particular patient comes in one day and tells me that he is sick and tired of his neighbor’s ducks eating from his mango tree and pooping on his lawn. His solution: inject the mangoes with industrial-force insecticide to kill the ducks. Ducks and mango trees are very common in Florida. So he goes on and on telling me how he is going to trick these ducks to eat the poisoned mangoes and kill them. I naturally tried to discourage this.

Well, the next week, I get a call that this patient is in the waiting room for me. When I go out to see him, he says “I have a present for you.” He was completely serious. Both of his arms were extended and in each hand were... two large mangos!!!! He didn’t understand why I refused to take them and to this day, I wonder if he poisoned them. And that my friends is the story of the Mango Man.

You can't make this stuff up (#3)

One of the things I need to do in my job is ask patients about substance abuse history because use of alcohol and illegal drugs can affect thinking abilities, depending on how significant the history of use was. So I am interviewing a patient about this topic who is telling me about how someone in his house was arrested for selling drugs. He tells me that he was also arrested. I asked why he was arrested and he started to clam up. "Were you selling drugs too?" I asked. The patient looked away, seemed embarrassed and said, "Well, not by the law."

REALLY???!!!!!!! That has to be the quote of the year.

You can't make this stuff up (# 2)

A few years ago, I was walking into work and saw one of my patients in the waiting room. She was sitting next to a stuffed animal (a sheep) which had headphones on it with music blasting. The stuffed sheep was taking up its own separate seat. The patient had arrived for a feedback session. This was when I was still in training and my boss at the time wanted to get the point across to her that there was a psychological component to her symptoms (which she was blaming entirely on a head injury). The patient was upset and did not agree and demanded examples of something showing there was a psychological problem. My boss mentioned that one easy example is that she is sitting in the office with a stuffed teddy bear with music blasting in the headphones. The patient looks at us like we are crazy and says "It's not a stuffed teddy bear...It's a sheep!"

Know your doctor

I should really have entitled this entry "You Can't Make This Stuff Up" part 2, but I don't want to wear that title out. Basically, I had a patient whose family friend referred him to a neurologist for help for a problem he had been having. To make a long story short, the neurologist diagnosed the patient with a serious medical disorder he never had, put him on several strong medications for it, which then made the patient worse due to side effects. Like many people, even though the patient sensed something was wrong, he did not challenge the doctor at first because "The doctor must be right." But eventually the symptoms from the medications became so severe that the patient stopped seeing the doctor. Then the patient hired a lawyer and did some research and found out the doctor had his license suspended for various reasons, one of which included attacking a patient. I typed in the name of the doctor on Google just to check it out for myself and lo and behold, the information the patient told me was true.

There are many medical websites out there which purport to do background checks on physicians and I have no idea if they are good or not, but all charge a fee and it is probably unrealistic to expect you are going to pay for a search before you visit each new doctor. But why not at least do a quick Google search before you go to that appointment? You never know...

You can't even make this stuff up (#1)

I see alot of weird stuff every week in my job. There is a famous expression that truth is stranger than fiction and I can vouch for that. Each week, I hear some kind of story from a patient that makes me say to myself, "You can't even make this stuff up." So I decided to periodically do some blog posts with this quote as the title and this is the first entry. Please note that I need to keep information somewhat vague because I cannot provide any details that would identify my patients.

Anyway, the 1st brief story is as follows. I am interviewing a patient who got into a car accident after speeding around a corner at night in a residential neighborhood. The car completely lost control and crashed into a person's living room! As I do in all cases, I asked if their are any pending lawsuits. So the patient said yes. I asked him to provide specifics (assuming he was the one who was being sued) but to my surprise he said he was the one who filed the lawsuit. He also said he was suing the person whose house he crashed into. When I asked why he was suing this person, the patient said "Because he built his house to close to the curb" (!!!!).

Bedside manner - part 2

A friend of mine saw a gynecologist for a problem involving one of the ovaries that eventually required surgery. To make a long story short, the gynecologist (who was herself pregnant) told my friend "Your chances of having children are so low (about 10%) that I would not bother trying." My friend was devastated and crying after hearing this. What kind of advice was this?! How does a doctor say that to someone, especially knowing how sensitive that matter is. If someone has a 10% chance of having children, it is still worth trying. Turns out, less than one year later, my friend had two beautiful and healthy children the natural way. It probably goes without saying, but yes, my friend send that doctor a picture of the 2 babies and reprimanded her prior words. At least this story has a good ending.

Bedside manner - part 1

Before I became a doctor, there were two experiences I had with physicians that reminded me how important bedside manner is. The first was when I was a student in college and I had severe headache, which made me go to the Emergency Room. I had a suspicion that it was caused by an odd way I was sitting in my dorm room when studying, in which my neck was pressed up aganst a cement wall for long periods. As weird as this sounds, it was actually comfortable because I had a pillow behind my neck. So when the ER doc was taking the history, I told him I thought this might be the reason. The response I got was a nasty, "I'm the doctor here. So let me be the one who figures out what's wrong, ok?" That is called God complex and many doctors have it. When I have patients, I always ask them their opinion on what they think is casuing a certain problem. Sometimes, they provide valuable insights that I would never have considered. Stay tuned tomorrow for part two. Share your bedside manner stories here. Click here for the next post.

Terrell Owens..was it a suicide attempt?

I guess we'll never know for sure if Terrell Owens, the famous football player for the Dallass Cowboys, tried to commit suicide now that it seems like everything about the case has been released. Terrell outright denies a suicide attempt. I wasn't there, but my big question is why would the police have made up the story that his publicist had to physically restrain him from putting pills in his mouth (something she later denied)? I don't understand how that actually finds its way into a police report unless that is something that was said at some point. Also, his publicist said he has 25 million reasons to live, as if to say that money is all there is to live for and that rich people do not attempt suicide. Suicide occurs across all economic groups from poor to rich. Terrell Owens has been under intense media scrutiny for his on the field and off the field antics and eventually, this can wear a person down mentally to the point that despondency sets in. Just ask one of Terrell's friend's, Deon Sanders, how depressing that type of media scrutiny can be. In the end, we'll probably never know exactly what happened and maybe it was all just a mistake. What do you think?